Looking to distinguish their operations from the competition, many healthcare facilities continue to create foodservice environments that can serve as a difference maker in the eyes of the public. As such, many healthcare operators continue to incorporate sophisticated serveries, patient-focused room-service programs and, in some cases, high-end restaurants that can compete with local eateries.

Though a majority of hospitals produce more food at the retail level than at the patient level, healthcare operators cater to a diverse demographic that includes employees, patients and their visitors. To better meet the needs of these updated operations, the back-of-house has had to adapt, while never losing sight of patient needs.

"The menu is the key consideration when specifying equipment, especially in healthcare," says Douglas C. DeLuca, foodservice equipment sales for Elverson, Pa.-based Singer Equipment Co.'s Health Care Contract Division. "Geographically, hospital menus are very interesting, because they can vary significantly due to local fare. This means healthcare foodservice equipment can differ in Los Angeles as compared to Maine."

Unlike traditional restaurants, in healthcare operations it is important to consider bed count when specifying equipment. "The size and type of hospital, in addition to whether it offers traditional bedside service or room service, makes a difference," DeLuca says. "When we specify for kitchens providing room service, we are basically building a traditional restaurant inside the hospital. Chefs take tickets and make food to order that is delivered to patient's bedsides, similar to table service."

There are unique factors to consider when specifying warewashers, steam-jacketed kettles and reach-in refrigeration, which are a sampling of the main equipment items utilized in healthcare foodservice operations.

Warewashers

Warewashers play a key role in a hospital's food safety efforts. As a result, healthcare operations need to determine the quantity and type of food, along with the type of ware being used, when choosing a unit.

Nine times out of ten, hospitals will pair their warewashers with continuous or dedicated pot and pan washing systems, which utilize higher water pressure and longer wash cycles for more effective cleaning. These three-bay sinks typically feature wash pumps within the tanks. Operators can specify these units with a specific wash flow design to meet its unique needs.

Because they can accommodate such large quantities of dishes — 21,000 per hour — many healthcare operators specify flight type warewashers. And when specifying a warewasher for a hospital, it is a good idea to request that the unit feature a point of entry that measures six inches taller than normal to accommodate trays, DeLuca says.

To properly sanitize items, high temp warewashers, with final rinse temperatures of 180 degrees F, are recommended. These units typically include a booster heater that requires additional electrical capabilities.

"Hospitals need to use these high temp machines because chemical sanitation is generally avoided in healthcare settings," DeLuca says. "It's important to be careful with patients, who are susceptible to germs [and foodborne illness]. There is more responsibility that needs to be taken here in terms of food safety and sanitation in regards to patient health."

To determine a warewasher's capacity or throughput, healthcare operators can compare the ratio of usable cubic inches of wash area versus the unit's overall footprint. Throughput speed will determine how fast the system can wash items. "A common mistake in healthcare is not sizing the warewasher properly for the operation," DeLuca says.

In healthcare, space constraints in the kitchen are common, especially for the warewashing area. Regardless, it is best to purchase a larger unit that can handle increased capacities in the future. "The warewasher's footprint typically determines its placement," DeLuca says. "The warewashing area is usually the smallest section in the back of house. The last thing people think about when building a hospital is the kitchen, so it's important to be resourceful. It's generally best to get a big flight-type unit and a smaller pot washer to handle the many pots and pans these operations use."

Steam-Jacketed Kettles

Most often used in cook-chill applications, steam-jacketed kettles provide a heat transfer surface area larger than the same size stock pot, which results in faster heating and cooking. In addition, these kettles utilize less energy than stock pots on open burners, which helps keep kitchen temperatures cooler.

Those healthcare operations that reheat meals or simmer foods for long periods of time represent prime targets for steam-jacketed kettles. For example, operators can reheat and hold soups, sauces, pasta, stews, rice and meat until they need these menu items. Steam-jackted kettles help reduce food waste and simplify and standardize recipes. The kettle's larger single batch capabilities also reduce labor by eliminating the use of multiple stock pots. Tilting kettles further simplify product handling and enhance safety.

"Kettles should always be tilting, because they're easier to handle," says DeLuca. "Healthcare operators also should always specify a fill faucet, so kettles can be conveniently filled in one location. Sometimes, these are not included in order to save money, [but that is a mistake]."

Steam-jacketed kettles range in size from 6 to 40 gallons. "Once again, one of the most common mistakes is specifying the wrong size unit," DeLuca says. "Instead of utilizing a 40- or 60-gallon kettle, healthcare operators should consider installing two 10- or 12-gallon units, so there is less food waste."

Reach-in Refrigeration

"Refrigeration is key in healthcare," DeLuca says. "Operators should look for spec line refrigeration that is heavy duty. One of the biggest mistakes is specifying low-end refrigeration to save money. Any temperature variation can trigger illness in a sick person, so it's critical the best systems are used."

The size of the healthcare facility, menu and volume will determine the requirements for reach-in refrigeration.

Application represents another key factor when specifying these units. Reach-ins used on production lines where staff is frequently opening doors may require low air velocity or high humidity, which prevents foods from drying out.

"In hospitals, pass-thru models and/or roll-ins and reach-ins are typically used in combination," DeLuca says. When sizing these units, note that not all of the interior space may be available for storage, since evaporators, lights, tray slides and other components will consume some real estate inside the cabinet. "In healthcare foodservice operations, many items are prepped early and then stored," DeLuca says. "In this case, tray slides or roll in refrigerators are more labor-friendly."

In kitchens where space above a reach-in is limited, operators should consider specifying a unit with a bottom-mounted compressor despite the fact that it will reduce interior storage space and require installation of a door about one-half the height of a regular door. Although requiring greater clearance, top-mounted reach-in compressors can maximize available internal storage capacity. Remote and self-contained refrigeration systems represent other options.

"We specify remote compressors often, since these take heat out of the kitchen," DeLuca says. "These units provide easy access to fix, without disrupting the cooking line."

Almost any reach-in can be fitted with either one full-door or two half-doors.

"In terms of construction, reach-ins used in this segment should be stainless steel inside and out for durability and easy cleaning," DeLuca says.

Healthcare operators also need to determine cabinet electrical power requirements and available supply. Adequate ventilation is necessary to properly exhaust the refrigeration system's heat.

Both room service and traditional healthcare foodservice operations require air screens with these units.

"The specifier has to understand both the temperature and humidity in the room," DeLuca says. "Those are key factors when keeping temperatures safe inside reach-ins."

Whether washing, cooking or chilling, specifying the right unit can help healthcare operators increase efficiency, while cutting costs and enhancing food safety.